Incidence Of Nerve Lesions Research Articles

Management of peripheral nerve injuries using natural based biomaterials and their derivatives: Advances and prospective

AbstractThe management of peripheral nerve injuries is an important concern due to the their incidence of nerve lesions and inappropriate regeneration that follows severe injuries, which ultimately reduces the lives of patients with this condition. Different strategies have been investigated to repair severe nerve injuries with the improvement of motor and sensory regeneration. Although autograft remains the gold standard technique, an emerging number of research articles concerning nerve conduit use have been reported in the last few years. Nerve conduits aim to overcome autograft disadvantages, but they satisfy some requirements to be suitable for nerve repair. A universal ideal conduit does not exist since conduit properties have to be evaluated case by case; nevertheless, because of their high biocompatibility and biodegradability, natural‐based biomaterials have great potential to be used to produce nerve guides. Although they have many characteristics with synthetic biomaterials, natural‐based biomaterials are preferable because of their extraction sources; indeed, these biomaterials are obtained from different renewable sources or food waste, thus reducing environmental impact and enhancing sustainability in comparison to synthetic ones. This review highlights the recent progress in the development of natural‐based biomaterials and their derivatives for the management of peripheral nerve injuries.

Laryngeal nerve morbidity in 1.273 central node dissections for thyroid cancer

AimWe assess the prevalence and mechanism of recurrent laryngeal nerve (RLN) injury in central neck dissection (CND) for thyroid cancer. MethodsCND with intraoperative neural monitoring was outlined in 1.273 nerves at risk (NAR). RLN lesions were stratified according to: timing (during thyroidectomy versus CND), segmental vs. diffuse injury, mechanism, severity, location, number of lymph nodes dissected and metastastatic. EMG parameters were recorded. Results49/1.273NAR (3,8%) documented RLN palsy. 25 nerves were injured during thyroidectomy, 8 while CND. In 16 no precise moment or mechanism of injury was identified. A disrupted point could be identified in 19/25 (76%) and 7/8 (87%) respectively for thyroidectomy and CND steps. Diffuse injury, occurred in 24% and 12,5% respectively for thyroidectomy and CND. Nerves were injured in the all cervical nerve course without any major location for incidence for CND; for thyroidectomy most nerves were injured in the last 1 cm course. Traction (36%) was the leading cause of RLN injury for thyroidectomy. For solely CND, traction, entrapment and thermal injuries were equally frequent. Permanent vs. transient injuries were respectively 8% (4/49) and 92% (n.45/49), overall. Permanent lesions were equally distributed. ConclusionsDuring CND, RLN palsy still occurs with routine exposure of the nerve even combined with IONM. The incidence of nerve lesions during thyroidectomy is higher than that of CND.

Nervenläsionen nach minimal-invasiver Hüftendoprothetik

Although there is no clear evidence, minimally invasive hip arthroplasty seems to be associated with slightly higher complication rates compared to standard procedures. Major nerve palsy is one of the least common but most distressing complications. The key for minimizing the incidence of nerve lesions is to analyze preoperative risk factors, accurate knowledge of the anatomy and minimally invasive techniques. Once clinical signs of nerve injury are evident, the first diagnostic steps are localization of the lesion and quantification of the damage pattern. Therefore, clinical assessment of the neurological deficits should be performed as soon as possible. Apart from rare cases of isolated transient conduction blockade or complete transection, the damage pattern is mostly combined. Thus, there can be evidence for dysfunction of nerve conduction (neuropraxia) and structural nerve damage (axonotmesis or neurotmesis) simultaneously. Because the earliest signs of denervation are detectable via electromyography after 1 week, it is not possible to make any reliable prognosis within the first days after nerve injury using electrophysiological methods. This review article should serve as a guideline for prevention, diagnostics and therapy of neural lesions in minimally invasive hip arthroplasty.

Lésions du nerf sciatique en chirurgie de la hanche

Purpose of the study The incidence of neurological lesions after hip surgery is underestimated because of variable clinical expression and functional disorders resulting from nerve injury and often considered to be the normal course after hip surgery. The incidence of nerve lesions after hip surgery for fractures of the proximal femur remains to be detailed. Material and method This retrospective study included 20 cases of sciatic nerve injury following hip surgery (2554 THA, 394 revision THA, 4632 osteosyntheses or hemiarthroplasties of the proximal femur). We noted degree of recovery of the neurological deficit and deterioration of the patients’ quality-of-life. The prognosis was determined on the basis of clinical and electromyographic data. Results The incidence of nerve injury after hip surgery was 0.5% after THA, 1% after revision THA, and 0.08% after osteosynthesis or hemiarthroplasty of the proximal femur. The etiological factor remained unknown in the majority of the cases. The prognosis was tightly related to the type of neurological lesion as defined by the electrophysiological study. Three revision procedures were performed: two for drainage of a compressive hematoma and one to release the sciatic nerve (neurolysis). The prognosis depended on the type of neurological lesion as established by the electroneuromyographic study. Discussion Severe axonotmesis is associated with late recovery, generally incomplete recovery, and poor long-term functional outcome.

Marek's Disease in Chickens: Correlation of Marek's Disease with Nuclear-Inclusion Formation in Feather-Follicle Epithelium

The dynamics of nuclear-inclusion (NI) formation in feather-follicle epithelium of chickens inoculated with Marek's disease virus (with or without prior immunization with turkey herpesvirus) could be divided into two patterns: 1) transient NI formation at the initial stage postchallenge; and 2) persistent NI formation. Incidence of Marek's disease was closely correlated with the dynamics of NI formation. Active NI formation recurred in chickens showing pattern 2 and was closely related to the incidence of nerve lesions.